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The Open Nursing Journal

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RESEARCH ARTICLE

The Efficacy of Psychological First Aid Training Program on Academic

Faculties’ Knowledge and Competency to Deal with Students Experiencing
Traumatic Events: A Quasi-Experimental Study
Mohammad A. Abu Sabra1,*, Mahmoud Al Kalaldeh1 and Ayman M. Hamdan-Mansour2
1
Psychiatric Nursing, School of Nursing, The University of Jordan-Aqaba Campus, Aqaba, Jordan
2
School of Nursing, The University of Jordan, Amman 11942, Jordan

Abstract:
Background:
Academicians, nowadays, are assuming multiple roles, including psychological support. The need to enhance academicians’ knowledge and skills
related to psychological first-aid is increasing due to the significant and timely intervention that academicians might assume when their students
experience traumatic events.

Objective:
To assess the efficacy of the psychological first-aid training program on faculty members’ knowledge and competencies dealing with
undergraduate students experiencing traumatic events.

Methods:
One group pretest-posttest quasi-experimental design was used. Participated faculty members received a PFA training program which was
preceded and followed by an assessment of their knowledge and competencies using the PFA knowledge and competency questionnaire.

Results:
A total of 43 faculty members participated in the study. Faculty members’ knowledge and competency were improved after receiving the PFA
training program (knowledge means = 7.7 to 11.0, t= -15.7, df= 42, p= 0.00); Competency means = 17.2 to 33.0, t= -14.6, df=42, p=0.00). No
variation in the changes in knowledge and competency across study phases between demographic variables.

Conclusion:
Sustainable and up-to-date training on topics related to the psychological needs of students is a cornerstone to enhance the role of faculty members
in academic settings.

Keywords: Knowledge, Competency, Psychological first-aid, Student, Traumatic events, Questionnaire.

Article History Received: January 12, 2023 Revised: March 28, 2023 Accepted: April 07, 2023

1. INTRODUCTION gical harm and has a negative impact on a person’s attitude,

Students entering universities may have a variety of
traumatic experiences such as violence, death, abuse, mass
shootings, car crashes or accidents, and illness that have long-
term effects on their mental well-being and might lead to
severe forms of mental illnesses [1, 2]. A traumatic event is an
incident that causes physical, emotional, spiritual, or psycholo-
* Address correspondence to this author at the Psychiatric Nursing, School of
Nursing, The University of Jordan-Aqaba Campus, Aqaba, Jordan;
Tel: 00962-78-1579139; Fax: 00962 3 2090450; E-mail: m.sabra@ju.edu.jo
behavior, or other aspects of functioning [3, 4]. The unexpected
death of a loved one, family violence, unwanted sexual
attention, and sexual assault were the most common traumatic
events experienced and reported by university students (85%)
[5]. Students who suffer from a traumatic event may feel
threatened, anxious, frightened, sad, or angry. Moreover, they
may cry frequently, become irritable, have difficulty
concentrating and sleeping, as well as continuously think about
what happened, and become isolated from family and friends

DOI: 10.2174/18744346-v17-e230517-2022-2, 2023, 17, e187443462305020

2 The Open Nursing Journal, 2023, Volume 17
[4, 6]. Furthermore, no clear statistics on traumatic events
experienced by Jordanian undergraduate students have been
published in the last 20 years.
Psychological first-aid (PFA) is a set of helping actions
used to mitigate initial traumatic distress and assist in short-and
long-term adaptation in ways that respect the person’s dignity,
culture, and abilities [7, 8]. PFA is an evidence-based
supportive approach used to support survivors after exposure to
an incident of a disaster, or a traumatic event, and it aims to
promote coping and adaptive functioning [9, 10]. The potential
value of PFA training emphasizes educating and training
leaders in the public, on how to deal effectively with people
and students when they experience traumatic events. Therefore,
laypeople such as academicians can reduce delays in early
intervention if they are fully aware and competent in managing
the effect of traumatic events [11, 12]. Academicians have
been pushed to embrace new roles and accept greater
obligations, including providing psychological support as front
liners for students at risk or experiencing traumatic events [13].
The COVID-19 pandemic demonstrated a greater demand for
faculty members to provide psychological assistance to their
students and to be able to use their online courses as a source
of psychosocial help [14]. However, the question of whether
academics are willing to provide acceptable and necessary
psychological requirements for their students is invalid and has
not been thoroughly investigated. This study emphasizes the
efficacy of training faculty members to provide PFA for
students experiencing traumatic events.
A systematic review conducted by Forthal et al. [15],
which included nine studies, revealed that mental health first-
aid yielded a positive impact on trainees’ knowledge and
competencies in managing traumatic events. Further studies
supported the evidence that psychological first-aid training can
promote laypersons’ competency, attitude, knowledge, and
helping behaviors [16, 17]. According to Zhang and colleagues
[18], both PFA-related knowledge and competencies were
significantly improved after introducing PFA training in
academic faculty. Kılıç and Sims¸ eks [19] had proven the
effectiveness of PFA training on traumatic preparedness for
undergraduate students and suggested integrating PFA as part
Table 1. The Psychological First Aid (PFA) training program.
Sessions Component of Session Content
Session PFA definition and (A) An overview of PFA
number 1 framework (B) What PFA is and is 2. Problem-based learning focuses on working in followed by 30 minutes of
not
(C) Who, when, and
where PFA occurs
(D) Discussing and
sharing traumatic events.
Session Applying PFA action (A) Prepare-learn about
number 2 principles the situation
(B) Action Principle of
PFA: Listen, Look, Link
(C) Ending Work of PFA
Abu Sabra et al.
of the curriculum. Thus, the unintentional omitting effects of
traumatic events may produce psychological stress and
dysfunction among these age categories [20]. In addition,
establishing support is a social responsibility that should
include family members, friends, and social workers [9, 21].
This is a pioneering study conducted in the Arab world
addressing the use of PFA training programs directed at
academic faculty members’ knowledge and competencies in
dealing with undergraduate students experiencing traumatic
events. This study will prove beneficial to society, considering
that PFA plays a vital role in science today. The greater
prevalence of symptoms of a traumatic background among
university students justifies the need for a more effective
demand for PFA program training for life-changing teaching
approaches. Researchers assume that there are ways to
minimize the potential impact that an emergency or traumatic
situation may have on university students. Psychological first-
aid (PFA) is one approach for reducing negative mental
consequences [10].
1.1. Purpose of Study
The purpose of this study was to assess the efficacy of the
Psychological First-Aid (PFA) training program on academic
faculty members’ knowledge and competencies when dealing
with undergraduate students experiencing traumatic events.
2. MATERIALS AND METHODS
2.1. Design
A quasi-experimental; one-group pretest–posttest design
was used in this study to assess the efficacy of a PFA training
program.
2.2. Sample and Setting
The study program took place at the University of Jordan-
Aqaba Campus. This study was conducted in the period
between April-October 2022. The inclusion criteria for the
faculty members included (1) a full-time faculty member with
a master’s or Ph.D. degree; (2) having been a university
academic teacher for at least one year. Census sampling was
used in an attempt to approach all academic faculty members
eligible for the study.
Teaching Methods and Extra Resource and Time
Material
1. Didactics teaching Session lasts for 60 minutes
teams, oral and written communication, critical feedback
thinking and analysis, and explaining concepts.
3. Assignment, and distribution of a handbook
and pamphlet.
1. Didactics teaching Session lasts for 60 minutes
2. Video demonstration, followed by 30 minutes of
3. Problem-based learning focuses on Applying feedback
course content to real-world examples and
problem-solving
4. Task-based learning focuses on interactive
tasks and exercising
Efficacy of Psychological First Aid
(Table 1) contd.....
Sessions Component of Session Content
Session PFA-related scenario (A) Knowledge review
number 3 simulation (B) Simulation case
provision
(C) Role-playing
(D) Summary and
feedback
Note: PAF; Psychological First Aid
2.3. Interventions
Participants involved in the study were exposed to the PFA
training program developed by Zhang et al. [18]. The original
PFA training program contents were designed according to the
guidelines: “Psychological First Aid: Facilitator’s Manual” for
orienting field workers (English version) and “Mental Health
Handbook for the Public” [7, 22]. Permission was obtained
from the primary author to make some changes to adapt to the
Jordanian culture. Adaptation includes the social, cultural,
spiritual, mental, and economic context of Jordanian people to
carry out the intervention according to the specified
administration guidelines to ensure that therapy is delivered
consistently across settings, therapists, and academic faculties.
For example, information related to the pattern of family and
communication in families and gender-role assumption in
Jordan families have been addressed. A guideline for
administering the PFA training program was considered to
ensure consistent delivery across all sessions. In this study, the
Arabic language has been used for program material delivery
depending on psychological first-aid: Guide for field
workers—Arabic version [23].
The PFA training program was implemented in three
sessions. Each session consisted of comprehensive content and
teaching methods that lasted 60 minutes, followed by 30
minutes of feedback, with a half-hour break between sessions.
All sessions occurred on the same day, and participants were
included in one group. The major teaching methods were
didactics, video demonstrations, situational teaching, case-
based learning, assignment, distribution of a handbook and
pamphlet, interactive exercises, and other teaching strategies.
The researcher was a nurse with a Ph.D. degree in psychiatric
nursing, certified as a Clinical Nurse Specialist-psychiatric
mental health nursing, and qualified to use and apply the
training program package. The PFA training program consisted
of; (1) PFA definition and framework, emphasizing; (A) an
overview of PFA, (B) what PFA is and is not, and (C) who,
when, and where PFA occurs, as well as (D) discussing and
sharing traumatic events. (2) Applying PFA action principles
focused on; (A) To prepare-learn about the situation, (B) the
action principle of PFA: listen, look, link, (C) ending the work
of PFA, (3) PFA-related scenario simulation, with an emphasis
on (A) knowledge review, (B) simulation case provision, (C)
role-playing, and (D) summary and feedback (Table 1).
2.4. Data Collection Procedure
The assessment was performed before and after conducting
the PFA training. The researchers performed a screening of the
faculty members’ records to ensure the eligibility of faculty
members for the study and met the inclusion criteria. All
eligible faculty members were provided with a brief description
The Open Nursing Journal, 2023, Volume 17 3
Teaching Methods and Extra Resource and Time
Material
1. Situational teaching Session lasts for 60 minutes
2. Role-playing followed by 30 minutes of
3. Interactive exercising feedback
4. Summary and feedback
of the study, which included all information regarding their
roles, rights, and confidentiality measures. The researcher was
a nurse with a Ph.D. degree in mental health nursing, certified
as a Clinical Nurse Specialist, and was eligible to use and apply
to the training program. The faculty members participated in
the study, completed the questionnaires in two stages, and
submitted them directly to the researcher in a closed envelope.
2.5. Instruments
The assessment conducted before and after the training
program used the following instruments:
1. Demographic questionnaire: The demographic questio-
nnaire was designed to collect the following information about
the participants: age, years of experience, gender, educational
level, college name, place of residence, and whether they
previously participated in a PFA training program.
2. The PFA knowledge and competency questionnaire
were used to measure the level of PFA-related knowledge and
competency of the sample. The PFA knowledge and
competency questionnaire were adopted by Zhang and
colleagues [18]. The questionnaire originated from the WHO
PFA facilitator’s manual, including a knowledge dimension
with 15 items and a self-assessment competency questionnaire
with nine items, which were used to add all items directly [7].
The PFA knowledge questionnaire items were rated
dichotomously using 1 for “yes” or 0 for “no.” Higher scores
represent a higher level of knowledge. Examples of yes/no
questions from the knowledge questionnaire include ‘most
affected people developing a mental disorder’; ‘ most affected
people needing specialized mental health services’. The other
questions are related for people who have experienced very
traumatic events such as ‘asking people to recount some of the
details of their traumatic experiences’ and ‘taking time to be
sure it is safe to approach the scene of a traumatic event even if
you must act urgently’.The self-assessment competency
questionnaire was rated using a 5-point Likert scale. Each
item’s score ranges as follows: 1 (very low), 2 (low), 3
(medium), 4 (high), and 5 (very high). Higher scores indicate a
higher level of self-competency. Examples of the competency
questions including the respondent’s self-rating to the
following items: ‘the ability to support people who have
experienced disasters or other extremely stressful events’; ‘the
ability to prepare and approach a traumatic situation safely’.
Testing competency tool reliability revealed higher internal
consistency in the pre and post-tests using Cronbach’s α test as
follows 0.79 and 0.83, respectively.
2.6. Data Analysis
Preparation and managing the data included transferring
4 The Open Nursing Journal, 2023, Volume 17
questionnaire responses into the Statistical Package of Social
Sciences (IBM SPSS-version 25). Missings and outliers were
minimal and treated by rechecking the original hardcopy
forms. Descriptive statistics were used for demographics and
study variables, which included: means, percentages, standard
deviation (SD), and percentiles. The paired t-test was used to
analyze the differences in knowledge and competency between
pre- and post-PFA. In other words, the total scores of both
knowledge and competency tools were calculated to compare
changes in respondents’ perspectives. The independent t-test
was used to examine the variation across demographic
characteristics and determine the factors influencing the
efficacy of PFA training outcomes. The level of significance
was set at 0.05 for all statistical measures.
2.7. Ethical Consideration
Prior to data collection, the Institutional Review Board
(IRB) of XYZ University granted ethical permission
(1/2022/389). Consent was obtained from all participants
before commencing the study. All participants were informed
about all ethical measures undertaken in the study, including
anonymity, rights of rejection and withdrawal, and
confidentiality.
3. RESULTS
Fifty-five academic faculty members met the inclusion
criteria. Twelve academic faculty members refused to
participate in the study for personal reasons. Forty-three
academic faculty members agreed to participate, signed the
consent form to participate, and received the PFA training
program. Therefore, 43 academic faculty members formed the
sample of this study and were included in the analysis.
3.1. Participants’ Characteristics
According to the data presented in Table 2, the average of
participants’ age was 46 years old. Participants’ academic
experience ranged from 2 to 15 years, with a mean of 8.7 years.
The majority of participants (69.8%) were males holding a
Ph.D. degree (74.4%). Concerning their distribution over
different university schools, the highest contribution was
reported from humanities schools (65.0%), while the rest were
drawn from other schools. None of the participating faculties
had previously participated in any PFA or similar training
programs.
Table 2. Faculty members' demographic characteristics (N = 43).
Variables
Age,Mean (SD)
Gender
Schools
Education Level
Abu Sabra et al.
3.2. Assessment of Knowledge and Competency before and
after the PFA Training
The results related to the assessment of knowledge before
and after the delivery of the PFA training program are
presented in Table 3. Based on the table, the participants’
knowledge mean was 7.7 (SD1.3) out of 15, indicating a low to
moderate knowledge level of traumatic event management.
However, the knowledge scores increased to an average of 11.0
(0.8), indicating a high knowledge level in traumatic event
management. This shows a significant difference between the
two means (t= -15.7, p = .000).
Regarding the competency scores, participants scored a
low competency level of traumatic event management before
receiving the PFA training (mean: 17.2 (3.4) out of 45). After
the delivery of the PFA program, the participants demonstrated
a higher level of competency, as evidenced by higher self-
assessment scores of competency at 33.0 (3.3) out of 45. This
difference in means yielded a significant statistical difference (t
= -14.6, p = .000).
These results indicated that the PFA training program
improved the academic faculty’s knowledge and competency
based on their perspectives and self-assessment.
3.3. Variations across Demographic Characteristics
The assessment of changes in knowledge and competency
across different demographic variables demonstrated the
following:
1. There were no significant differences between male and
female participants regarding changes in knowledge (t=0.84,
df=41, p=0.41) and competency (t=-0.48, df=41, p=0.64)
scores before and after the study program.
2. There were no significant differences between master’s
degree and Ph.D. degree holders regarding changes in
knowledge (t=-1.22, df=41, p=0.23) and competency (t=1.65,
df=41, p=0.11) scores before and after the study program.
3. There were no significant correlations between
participants’ age and changes in their knowledge (r=0.122,
p=0.44) and competency (r =0.204, p=0.19) scores before and
after the study program.
4. There were no significant correlations between
participants’ length of academic experience and changes in
their knowledge (r=-0.017, p=0.91) and competency (r =0.095,
p=0.55) scores before and after the study program.
Categories n (%)
46.7 (6.1)
Range: 36–59
Male 30 (69.8%)
Female 13 (30.2%)
Humanities Schools 28 (65.0%)
Scientific Schools 12 (28.0%)
Health Schools 3 (7.0%)
Master 11 (25.6%)
Ph.D. 32 (74.4%)
Efficacy of Psychological First Aid
(Table 2) contd.....
Variables
Years of Experience, Mean (SD)
Previously Participated in the PFA Training Program
Note: PAF: Psychological First Aid; SD: Standard Deviation
Table 3. Main variable comparison between pre-test and post-test.
Variables Pre-test Post-test
mean (SD) mean (SD)
Knowledge 7.7 (1.3) 11.0 (0.8)
Competency 17.2 (3.4) 33.0 (3.3)
Note: SD: Standard Deviation; df: Degrees of Freedom; SE: Standard Erorr; CI: Confidence Interval
4. DISCUSSION
Innovation and advanced technology in education at
various levels of academia have forced academicians to adopt
new roles and assume more responsibilities toward their
students. The COVID-19 pandemic showed a greater need for
faculty members to psychologically support their students and
be able to use their online courses as one main psychosocial
support. However, whether academicians are willing to provide
appropriate and needed psychosocial needs for their students is
not valid and has not been investigated adequately. This study
emphasizes the efficacy of training faculty members to provide
PFA for students experiencing traumatic events. The results of
this study showed that faculty members have a low level of
PFA-related knowledge and competencies before conducting
the PFA training program. However, the psychological first
aid-training program has significantly improved PFA-related
knowledge and competencies. Although it seems logical that
those who received training will have an increment of
knowledge and competencies related to PFA, the greater
inference of this study sustains the notion of the need to have
trained faculty members due to evidence at baseline where they
reported a low level of knowledge and competency. Moreover,
the study added that the assumed role for faculty members to
use psychosocial support and minimal psychological PFA
intervention would be a significant enhancement of their role
and might contribute to saving the lives of students who are at
high risk and might be mentally exhausted due to the traumatic
effects. In particular, the content of the training, which aimed
at reforming and strengthening the faculty members’ ability to
deal with undergraduate students experiencing traumatic
events, might have alarmed the faculty members to assume
their additional roles as significant supportive persons and role
models for students who they trust and listen to. As
hypothesized, faculty members’ knowledge and competencies
related to PFA have improved directly in the post-training
program.
The study findings supported the previous literature
regarding the association between knowledge and skill of the
individual's ability to deal with traumatic events [18]. The PFA
training program used in this study has bifocal benefits,
increasing the level of knowledge about psychological first-aid
and enhancing the level of competency in dealing with students
facing traumatic events [24]. Such particular information has
been addressed by Movahed et al. [25], who linked PFA
The Open Nursing Journal, 2023, Volume 17 5
Categories n (%)
8.7 (2.8)
Yes 0 (0%)
No 43 (100%)
Paired t- test df SE P-value CI
(t)
- 15.7 42 0.21 .000 -3.78 to -2.92
- 25.9 42 0.61 .000 -17.10 to -14.63
training to providers’, levels of knowledge and competency in
helping individuals experiencing traumatic events. This study,
on the other hand, supports previous efforts that using such
training has contributed to improving the knowledge and skills
of professional and non-professional health personnel [26 - 28].
It is important to mention that the need for training seems to be
for all those who might be in the position and are required
directly or indirectly to provide psychosocial support. Mental
health and psychosocial support are essential for everyone.
Therefore, all those, whether in academic or non-academic
settings, should be trained in PFA and psychosocial support
skills.
According to Lee and colleagues [13], faculty members
might act and assume the role of front liners for students at risk
or suffering traumatic events. This infers that the lack of skills
and knowledge of faculty members to manage such a situation
might jeopardize the situation and endanger the lives of
students. Being able, at least, to use the minimal level of skills,
find and identify those in need of psychological care and make
the appropriate advice of referral might save the lives of
students. For instance, asking students to recount some of the
details of their traumatic experiences, taking time to be sure if
it is safe to approach the scene of a traumatic event, even if you
must act urgently, telling them the story of someone else you
just helped so they know they are not alone, giving any
reassurance that would help them feel better, being sure to say
only what you know and not to make up information that you
do not know, judging the person’s actions and behavior so they
would not make the same mistake next time, telling an affected
person how they should be feeling, practicing self-care by
taking regular breaks, and talking with someone you trust about
your experience, etc. The researchers in this study support the
psychological support role of the faculty members and do not
limit their role to material endorsement and teaching. They are
willing to assume their roles as role models and knowledgeable
persons willing to provide assistance and show understanding.
This is one reason behind proposing the PFA-training program
to faculty members to ensure the improvement of PFA-related
knowledge and competencies in dealing with students
experiencing traumatic events and being able to intervene
timely and appropriately.
4.1. Limitations and Recommendations
A larger sample size would add additional strength to the
study. In addition, including a cluster sample that integrates
academic staff from different sectors, such as the government
6 The Open Nursing Journal, 2023, Volume 17
and private universities, would provide more generalizable
findings.
CONCLUSION
Based on this study training program, which integrated
various teaching methods, faculty members have been
equipped with higher knowledge and the ability to deal with
students experiencing traumatic events. The study indicated
that the training program was effective in promoting faculty
members’ knowledge and competencies in PFA to deal with
students who have experienced traumatic events. The merit of
our training program was particularly achieved through using a
variety of teaching methods that would build the basis for
giving psychological support to those students affected by
traumatic events. Furthermore, this study found that the ages
and length of the academic experience of academic staff may
not be influential in improving knowledge and competency in
dealing with PFA instances. Thus, PFA is an extremely useful
resource for faculty and should be implemented across
educational settings regardless of the academic staff’s age or
length of academic experience.
ETHICS APPROVAL AND CONSENT TO
PARTICIPATE
Prior to data collection, the Institutional Review Board
(IRB) of XYZ University granted ethical permission
(1/2022/389).
HUMAN AND ANIMAL RIGHTS
No animals were used in this research. All procedures
performed in studies involving human participants were in
accordance with the ethical standards of institutional and/or
research committees and with the 1975 Declaration of
Helsinki, as revised in 2013
CONSENT FOR PUBLICATION
Consent was obtained from all participants before
commencing the study. All participants were informed about
all ethical measures undertaken in the study, including
anonymity, rights of rejection and withdrawal, and
confidentiality.
STANDARDS OF REPORTING
COREQ guidelines were followed.
AVAILABILITY OF DATA AND MATERIALS
The datasets used in the current study are confidential and
available from the corresponding author [M.A.S.] on
reasonable request.
FUNDING
None.
CONFLICT OF INTEREST
The authors declare no conflict of interest financial or
otherwise.
Abu Sabra et al.
ACKNOWLEDGEMENTS
Declared none.
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